Tap what applies. The patient letter and prescriber letter write themselves. Click into either letter to edit before downloading. Nothing is saved: close the tab and it's gone.

Start from the JotForm assessment

Open her Sexual Health & Desire Assessment submission, copy all the answers, paste here, and press Fill in. It stays on this computer.

Patient

First name

Distress (0–10)

Last name (prescriber letter)

DOB (prescriber letter)

Letter date

What she reported

Low desire / less initiatingUsed to feel satisfied, wants it back Orgasm harder than it used to be Orgasm has always been somewhat hard Responsive desire intactBody responds once started; intimacy feels worth it Mild dryness at most, no pain Pain with sex Body image, mood, or stress getting in the wayShows in "why" and goals, even if she doesn't want counseling

Contributors & plan

Antidepressant side effectCreates the prescriber letter

Medication

Dose

Suggest lowering dose Suggest adding bupropion

GLP-1 medication (possible contributor)

Medication

Testosterone

Vaginal estrogen

Lubricant as needed Mindfulness-based CBT referralBody image, mood, anxiety

Other hormones she's on

Estradiol Progesterone

Chart note only

Additional plan items (one per line; not shown to patient)

Signed by

Patient letter

Prescriber letter

Chart note

The patient page link is built from the checklist, so edits typed into the letter below do not carry over to it. Edits stay in the letter until you change a checkbox or press Reset.

The Menopause Clinic

Specialized perimenopause, menopause, and women's sexual health care.

In-person visits in New Orleans, Louisiana
Telehealth available across Louisiana

700 Camp St, Suite 203
New Orleans, LA 70130
By appointment only

504-389-2078
info@menopauselouisiana.com

Care without the phone tag
Our clinic uses a message-first communication model so your questions are documented, routed correctly, and reviewed by the right team member.

Current patients: use the patient portal for all clinical questions, medication concerns, and refill requests.
New patients: text or email us — it's the fastest way to reach our team.
Scheduling or general questions: leave a voicemail and we'll follow up during business hours.

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We are an out-of-network, cash-pay specialty clinic and do not participate directly with insurance plans. Some patients choose to submit a superbill for possible out-of-network reimbursement and/or use HSA for membership payments (please check with your plan administrator) Labs and medications are often covered separately by insurance.